What Is High Cholesterol?
Cholesterol is a substance that your liver produces
naturally. It’s vital for the formation of cell membranes, vitamin D, and
Cholesterol is a waxy, fat-like substance. It doesn’t
dissolve in water and therefore can't travel through the blood by itself.
Lipoproteins are other particles formed in the liver that help transport
cholesterol through the bloodstream. There are several major forms of
lipoproteins that are important to your health.
Low-density lipoproteins (LDL), also known as "bad
cholesterol," may build up in the arteries and lead to serious health
problems like a heart attack or stroke. High-density lipoproteins (HDL),
sometimes called "good cholesterol," help return the LDL cholesterol
to the liver for elimination.
Your liver produces all the cholesterol that you need, but
fats and cholesterol are present in many of the foods we eat nowadays. Eating
too many foods that contain excessive amounts of fat increase the level of LDL
cholesterol in your blood. This is called having high cholesterol. High
cholesterol is also called hypercholesterolemia. High cholesterol is especially
dangerous when HDL cholesterol levels are too low and LDL cholesterol levels
are too high.
High cholesterol typically causes no symptoms. It’s
important to eat healthy and regularly monitor your cholesterol levels. When left
untreated, high cholesterol can lead many health problems including a heart
attack or stroke.
What Causes High Cholesterol?
High cholesterol is usually made worse by eating too many
unhealthy foods that are high in cholesterol, saturated fats, and trans fats. Examples
of foods that contribute to high cholesterol include:
- red meat
- liver and other organ meats
- full fat dairy products like cheese, milk, ice cream,
- eggs (the yolk)
- deep fried foods, like potato chips, french fries,
fried chicken, and onion rings
- peanut butter
- some baked goods, like muffins
- processed foods made with cocoa butter, palm
oil, or coconut oil
High cholesterol can also be genetic in many cases. This
means that it’s not simply caused by food, but by the way in which your genes
instruct your body to process cholesterol and fats. Genes are passed down from
parents to children.
Other conditions like diabetes and hypothyroidism may also
contribute to high cholesterol. Smoking can also increase cholesterol problems..
Who Is at Risk for High Cholesterol?
Over one-third of American adults have raised levels of LDL
or "bad" cholesterol, according to the Centers for Disease Control and
Prevention (CDC). People of all ages,
ethnicities, and genders can have high cholesterol.
You may be at a higher risk of high cholesterol if you:
- have a family history of high cholesterol
- eat a diet containing an excessive amount of
- are overweight or obese
- have diabetes, kidney disease, or hypothyroidism
What Are the Symptoms of High Cholesterol?
In most cases, high cholesterol is a silent problem that typically
doesn't cause any symptoms. For most people, if they have not had regular
checkups and followed their cholesterol levels, their first symptoms are events
like a heart attack or a stroke. In rare cases, there are familial syndromes
where the cholesterol levels are extremely high (familial hypercholesterolemia).
These people have cholesterol levels of 300 milligrams per deciliter (mg/dL) or
higher. Such people may show symptoms
from high cholesterol that are due to deposits of cholesterol (xanthomas) over
their tendons or under their eyelids (xanthalasmas). While high cholesterol affects a large
portion of the United States, familial hypercholesterolemia affects only about one
in 500 people.
How Is High Cholesterol Diagnosed?
High cholesterol is very easy to diagnose with a blood test
called a lipid panel. Your doctor will take a sample of blood and send it to a
laboratory for analysis. Your doctor may ask that you don’t eat or drink
anything (fast) for at least 12 hours prior to the test.
A lipid panel measures your total cholesterol, LDL
cholesterol, HDL cholesterol, and triglycerides. The Centers for Disease
Control and Prevention (CDC) defines the following blood cholesterol levels
as "desirable", or what you should aim for):
- total cholesterol: less than 200 mg/dL
- LDL cholesterol: less than 100 mg/dL
- HDL cholesterol: 40 mg/dL or higher
- triglycerides: less than 150 mg/dL
These recommendations are for the general, healthy
public. Cholesterol levels may be
different if you already have other conditions like diabetes. Your doctor can
tell you what your healthy levels should be.
How Is High Cholesterol Treated?
Committing to exercise and a healthy diet is usually enough
to decrease cholesterol levels. Sometimes medication is needed. This is
especially true if LDL cholesterol levels are very high.
The most commonly prescribed medications used to
treat high cholesterol are called statins. Statins work by blocking your
liver from producing more cholesterol. These drugs also indirectly decrease the
blood levels of LDL cholesterol and triglycerides and some of them may also
raise the level of the “good” cholesterol, HDL.
of statins include:
- atorvastatin (Lipitor)
- fluvastatin (Lescol)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
Other medications for high cholesterol include:
- bile acid resins or sequesterants like colesevalam
(Welchol), colestipol (Colestid), or cholestyramine (Prevalite)
- cholesterol absorption inhibitors, such as
There are also combination
products that decrease both the absorption of the cholesterol you eat and also
reduce the production of cholesterol in your liver. One example is a
combination of ezetimibe and simvastatin (Vytorin).
Since a person's lifestyle typically worsens high
cholesterol, lifestyle changes are crucial in order to lower it. Take these steps to help lower your
- Eat a diet low in saturated and trans fats. Lean
meats, such as chicken and fish that are not fried, and lots of fruits,
vegetables, and whole grains are helpful. Avoid fried or fatty foods as well as
too many carbohydrates and processed sugars
- Eat fish containing omega-3 fatty acids, which may
help lower your LDL cholesterol. Salmon, mackerel, and herring, for example are
rich in omega-3s. Walnuts, ground flaxseeds and almonds also contain omega-3s.
- Avoid excessive amounts of alcohol.
- Exercise at least 30 minutes a day, five days a
- Quit smoking.
Herbal and Nutritional Supplements
Some foods and supplements have been suggested to help lower
your cholesterol, although none have been clearly proven to do so. These include:
- oat bran (found in oatmeal and whole oats)
- blond psyllium (found in seed husk)
- ground flaxseed
Certain herbs have also been suggested to be beneficial. The
level of evidence supporting these claims varies. None have been approved by
the U.S. Food and Drug Administration (FDA) for treatment of high cholesterol. Some of these include:
- olive seed extract
- green tea extract
Always talk to your doctor before taking any herbal or
nutritional supplement. The herbal supplement may interact with other
medications you take.
What Types of Doctors Treat High Cholesterol?
Your primary care doctor will typically be the first type of
doctor to measure your cholesterol levels. A lipid panel is normally done
during a routine physical exam with your primary care doctor. They may refer
you to a specialist if you are at a high risk of heart disease. For example, if
you are overweight or you have a hard time adhering to a diet low in saturated
fat or getting regular exercise.
Specialists who treat or help manage high cholesterol
include the following:
are doctors who specialize in disorders of the heart. A cardiologist may be
necessary if you are already experiencing more serious complications from
having high cholesterol like high blood pressure or atherosclerotic heart
or registered dietitians are professionals
who can help analyze your current diet. They can help you make a personalized
cholesterol-friendly diet based on what foods you like and dislike.
are doctors who specialize in the study of fats in the blood. This is an
emerging branch of medicine with relatively few practitioners. Although
specialized training is available in lipidology, the American Board of Medical Specialties
has yet to recognize lipidology as an independent medical subspecialty. A
lipidologist may be able to offer additional therapeutic options if cholesterol-lowering
medications and lifestyle changes don't help.
physiologists help people create a personalized plans to get engaged in
more exercise and physical activity. They are trained to help you get the
maximum heart benefits from your exercise plan.
are doctors who specialize in diagnosing diseases related to the glands. An
endocrinologist can help treat people who are dealing with hormonal imbalances.
What Are the Complications of High Cholesterol?
Left untreated, high cholesterol can contribute to plaque
formation in your arteries and lead to atherosclerosis. Over time, deposits of
cholesterol (plaque) can narrow your arteries and let less blood to pass
Atherosclerosis is a serious condition that can result in
many life-threatening complications. These complications include:
- heart attack
- angina (chest pain)
- peripheral vascular disease
- high blood pressure
- chronic kidney disease if plaque builds up in
the renal arteries, which supply blood to your kidneys
How Can High Cholesterol Be Prevented?
High cholesterol that’s caused by genetic factors can't be
prevented. There are things you can do to help lower your cholesterol to a more
desirable level or prevent it from ever becoming a serious problem:
- Exercise regularly.
- Eat a healthy diet low in animal fats.
- Eat baked, broiled, steamed, grilled and roasted
foods instead of fried foods.
- Choose lean meat.
- Choose low-fat or fat-free dairy products.
- Avoid fast food and junk food.
- Eat a diet high in fiber.
- Don't smoke. Smoking injures the blood vessels
and greatly increases a person's risk for heart disease and stroke.
- Avoid excessive alcohol consumption. Although,
moderate alcohol consumption (no more than two drinks a day) can actually
raises levels of beneficial HDL cholesterol.
- Get your cholesterol checked regularly. The American
Heart Association recommends having your cholesterol levels checked every
four to six years if you are a health adult over the age of 20. You may need to
have your cholesterol checked more often if you are at an increased risk of
- Maintain a healthy weight.
What Is the Outlook for High Cholesterol?
If not treated, high cholesterol can cause serious problems
and even death.
Treatments for high cholesterol and heart disease have
improved over the years. Medicine and education have greatly reduced the number
of deaths caused by heart disease and other complications.
However, high cholesterol is still a major concern in the
United States due to sedentary lifestyles and poor food choices. Making
positive changes to your lifestyle, including eating a healthier diet and
getting more exercise, can help you live a long and healthy life.